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Student Support Programs Registration

Select a Program
Student Engagement Programs
Please select the program(s) you are interested in joining.
Contact Information
Home (Permanent) Address
Are you a current GRCC Student?
Optional Applicant Information
The following questions are optional and do not require a response. If you respond, please be advised that we use the information to design a support and referral plan of action.
Have you already taken CLS 100?
Were/Are you required to take: (check all that apply or skip this question if it doesn't apply)
Are you a first generation college student?
Are you a DACA or Undocumented Student? (This is only for the program staff to know how to best serve your needs and to find resources for your success. Your answer is confidential and will not be reported to any organizations or entities.)
Please indicate how you identify racially/ethnically
Short Answer Questions
What are your educational goals: (check all that apply)
One file only.
100 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.
Signature

Student Clearance and Approval

I understand that by signing this form, the information I provide is accurate to the best of my knowledge. My signature will serve as my indicated commitment to the selected Student Engagement Program(s) at GRCC.

I understand that the indicated Student Engagement Program(s) of interest will use information for educational purposes only.

I am authorizing the indicated Student Engagement Program(s) of interest to share and/or obtain information with the registration, advising and counseling, financial aid office, instructors, administrators, student life office, and any other relevant GRCC staff or faculty person who has a vested interest in my academic success and overall well-being.

Signature
Transfer